New year brings sharp rise in Massachusetts flu cases

Tuesday

Influenza activity is trending upward in Massachusetts and tracking slightly worse than last year, one of the most challenging flu seasons in recent history.

Public health officials reported a sharp increase in the number of flu and flu-like illnesses around the turn of the new year, marking a trend likely to continue through the end of flu season, usually March.

“The flu season is well underway,” said Dr. Lawrence Madoff, director of the Epidemiology and Immunization Division at the state Department of Public Health. “It’s tracking very similar to last year’s season, which was a severe one.”

DPH tracks the flu in different ways, including as a percentage of total visits to doctors’ offices, school nurses, community health centers and some emergency rooms.

As of Jan. 18, the state counted 3 percent of patients with flu or flu-like illnesses, which may stem from other types of illnesses, but include a fever above 100 degrees and a cough or sore throat. The northeastern part of the state reported the highest density of cases, followed by the southeast and central parts of the state.

A year earlier, the state total was slightly less, totaling 2.9 percent for the week ending Jan. 12, according to state figures. The number skyrocketed to 5.9 percent on Feb 9, before starting to decline. The flu ultimately killed tens of thousands of people across the country, according to the Centers for Disease Control and Prevention. At least one child died in Massachusetts.

The state tracks pediatric deaths related to the flu. As of Jan. 17, DPH reported zero child deaths.

“Last year was one of the worst years,” said Dr. Alain A. Chaoui, president of the Massachusetts Medical Society, headquartered in Waltham.

This year, the most-common flu strain is H1N1, according to Madoff, differing from last year when the H3N2 strain swept Massachusetts and the rest of the nation.

The flu changes year to year because the virus either “drifts,” or “shifts.” When it drifts, the genetic change is small and less likely to successfully attack an immune system with built-up antibodies. When the flu shifts, there is an abrupt change to the genetic formation, and most humans don’t have immunity to the new virus.

A shift happened in 2009 when the H1N1, known better as the “swine flu,” introduced a new combination of genes and ultimately fueled a pandemic. The CDC estimates that between 2009 and 2010 there were 60.8 million swine flu cases in the United States.

“This is a strain that tends to affect younger people more than older people, but we’re seeing it in all age groups,” Madoff said.

The medical community largely agrees that getting a flu shot is still the best first line of defense against the flu, especially for young children and adults older than 65 years. The two age groups are more susceptible to dying while having the flu, even if the cause is technically from a separate illness.

“Flu vaccines have been shown to be life-saving in children, in addition to having other benefits,” the CDC reports.

The severity of last year’s flu season, which killed an estimated 79,400 people nationwide and was the most severe flu season since 2009, may have triggered an uptick in the number of people who got flu shots this season. The CDC reported the number of doses distributed totaled 166.6 million in December, already exceeding the total from last season.

But the surge in flu shots hasn’t necessarily translated to fewer flu cases so far, as numbers continue to climb.

The disparity, Chaoui explained, could be the result of many factors, including the simple fact that more people are seeing doctors with flu-like symptoms out of caution from last year. Also, the flu shot each year is based on equations and algorithms that try to predict the best vaccination each year, Chaoui said, which could go a long way toward reducing flu outbreaks but don’t work perfectly.

“It’s not a perfect science and nothing is 100 percent foolproof,” Chaoui said.

Nonetheless, he’s adamant people get the shot because the shot protects individuals and others with whom they come in contact.

“We are all responsible for what happens to our communities,” Chaoui said. “It’s very important for all of us to take responsibility and that starts by taking the flu shot.”

The flu also spreads in other ways and its proliferation is exacerbated by the immunity of different populations, along with weather. It also takes two weeks for the flu shot to take effect, meaning people are still susceptible to catching the illness before the vaccine kicks in.

Both Chaoui and Madoff continue to urge people to get the shot, as there are still weeks left in the flu season. Both doctors also say it’s paramount that individuals experiencing flu-like symptoms should stay home from work and school.

“Going to work and school when you’re sick is a good way to spread it to people,” Madoff said. “It’s an altruistic thing to stay home if you’re feeling sick.”

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